Experience with Multiload Cu 250 intrauterine device in general practice

There have been many studies on side effects and consequent removal of IUDs which had been inserted in hospital settings but little research has focused on the experience of women patients who had been fitted with IUDs by general practitioners in their own offices. A general practitioner himself the author conducted a 36-month retrospective study on 95 of his female patients between the ages of 15 and 44 who had had the Multiload Cu 250 spiral inserted. The study showed that the highest removal ratio (8.4/95) during the first year of use resulted from the occurrence of inflamation or infection. The second highest cause for removal (6.3) stemmed from excessive bleeding or pain. Women wishing for pregnancy accounted for the third highest removal ratio (3.2). A removal ratio of 2.1 was traced to unplanned pregnancy and 1.1 to natural expulsion from causes other than pregnancy. The study showed a significant reduction in side effects the longer the patients used the devices with no reported removal for inflammation/infection in the 23-36 month period and only 4.5 for the 13-24 month period. The ratios for removal due to bleeding/pain showed a similar trend down to 4.7 in the 23-36 month period (though this had been even lower in the 13-24 month period: 4.5). These figures generally correspond with results of an extensive Scandinavian multicenter study of IUD side effects. It is shown that attitudes of physicians to the discomforts of IUD use differ and that this influences the indication for removal.